Characterization of radial artery perforation patterns using optical coherence tomography

Area of Science:

• Cardiovascular Interventions
• Medical Imaging
• Vascular Surgery

Background:

• Radial artery perforation (RAP) patterns visualized by optical coherence tomography (OCT) require further characterization.
• This study addresses the lack of established RAP patterns using OCT in clinical practice.

Purpose of the Study:

• To identify and characterize radial artery perforation (RAP) patterns observed via post-procedural optical coherence tomography (OCT).
• To establish characteristic OCT findings for RAP following transradial coronary intervention (TRI).

Main Methods:

• Retrospective analysis of 1936 patients undergoing radial artery (RA) OCT after OCT-guided transradial coronary intervention (TRI).
• Collected data on RAP site, dimensions (length, width, arc), and classified perforations as small (arc ≤90°) or large.
• Utilized post-procedural OCT and radial artery angiography (RAA) for RAP identification and assessment.

Main Results:

• Radial artery perforation (RAP) occurred in 0.83% (16/1936) of patients.
• Median RAP dimensions: 30.6 mm from ostium, 1.55 mm length, 0.74 mm width, 42.5° arc.
• 87.5% of RAPs were small (arc ≤90°), and 93.7% sealed spontaneously or with compression.

Conclusions:

• Radial artery perforation (RAP) is an infrequent complication during TRI.
• OCT provides distinct patterns for characterizing RAP.
• Most RAPs are small and exhibit spontaneous sealing via catheter tamponade.